Tailored cognitive-behavioural therapy and exercise training improves the physical fitness of patients with fibromyalgia
SourceAnnals of the Rheumatic Diseases, 70, 12, (2011), pp. 2131-2133
Article / Letter to editor
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Epidemiology, Biostatistics & HTA
Annals of the Rheumatic Diseases
SubjectN4i 1: Pathogenesis and modulation of inflammation; NCEBP 2: Evaluation of complex medical interventions; NCEBP 2: Evaluation of complex medical interventions N4i 4: Auto-immunity, transplantation and immunotherapy; NCEBP 8: Psychological determinants of chronic illness; NCEBP 8: Psychological determinants of chronic illness N4i 4: Auto-immunity, transplantation and immunotherapy
OBJECTIVES: Patients with fibromyalgia have diminished levels of physical fitness, which may lead to functional disability and exacerbating complaints. Multidisciplinary treatment comprising cognitive-behavioural therapy (CBT) and exercise training has been shown to be effective in improving physical fitness. However, due to the high drop-out rates and large variability in patients' functioning, it was proposed that a tailored treatment approach might yield more promising treatment outcomes. METHODS: High-risk fibromyalgia patients were randomly assigned to a waiting list control group (WLC) or a treatment condition (TC), with the treatment consisting of 16 twice-weekly sessions of CBT and exercise training tailored to the patient's cognitive-behavioural pattern. Physical fitness was assessed with two physical tests before and 3 months after treatment and at corresponding intervals in the WLC. Treatment effects were evaluated using linear mixed models. RESULTS: The level of physical fitness had improved significantly in the TC compared with the WLC. Attrition rates were low, effect sizes large and reliable change indices indicated a clinically relevant improvement among the TC. CONCLUSIONS: A tailored multidisciplinary treatment approach for fibromyalgia consisting of CBT and exercise training is well tolerated, yields clinically relevant changes, and appears a promising approach to improve patients' physical fitness. ClinicalTrials.gov ID NCT00268606.
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